液基细胞学联合HPV基因分型检测在宫颈癌前病变筛查中的应用探讨

Discussion on the Application of Liquid Based Cytology and HPV Genotyping in the Screening of Cervical Precancerous Lesions

目的探讨分析液基细胞学联合HPV(human papillomavirus人乳头状瘤病毒)基因分型检测在宫颈癌前病变筛查中的临床应用价值。方法抽取在2013年1月—2014年8月间该院收治的380例经液基细胞学检查有异常的为非典型鳞状上皮细胞及以上的患者,对这些患者进行液基细胞学联合HPV(human papillomavirus人乳头状瘤病毒)基因分型检测,对研究结果进行回顾性对比分析。结果检查结果为非典型鳞状上皮细胞及以上患者同时合并HPV阳性患者有130例,其中ASCUS(非典型鳞状上皮细胞)、LSIL(低度鳞状上皮内病变)、HSIL(高度鳞状上皮内病变)、SCC(人鳞状细胞癌)的所占百分比分别为78(60%)、40(30.77%)、7(5.38%)、5(3.85%);130例患者中HPV高危型患者有48例,AUSCS、LISL、HISL、SCCHPV高危型患者所占百分比分别为22(27.85%)、17(42.5%)、4(57.14%)、5(100%),研究结果显示SCC和HPV高危型感染有直接的联系。HPV高危型患者有48例,平均年龄43.6岁;HPV低危型患者有82例,平均年龄32.7岁,差异有统计学意义(P<0.05)。结论采用液基细胞学联合HPV基因分型检测能够有效的诊断出宫颈癌病变,数据比较准确可靠,值得在临床上推广应用。

Objective To investigate the clinical application value of liquid based cytology combined with human papilloma virus （HPV） genotyping for the screening cervical precancerous lesions. Methods 380 cases with abnormal atypical squamous cells and more detected by liquid based cytology in our hospital from January 2013 to August 2014 were selected. HPV genotyping was per-formed in all the patients. And the results were analyzed comparatively and retrospectively. Results The test results showed that 130 cases with atypical squamous cells and more and positive HPV, which included 78 cases with atypical squamous cells of un-determined significance （ASCUS）, 40 cases with low-grade squamous intraepithelial lesion （LSIL）, 7 cases with high-grade squa-mous intraepithelial lesion（HSIL）, 5 cases with squamous cell carcinoma （SCC）, accounting for 60%, 30.77%, 5.38%, 3.85%, re-spectively. Of the 130 cases, 48 cases had high risk HPV, and among them, the number of patients with high risk AUSCS, LISL, HISL, SCCHPV was 22 cases, 17 cases, 4 cases, 5 cases, respectively, accounting for 27.85%, 42.5%, 57.14%, 100%, respective-ly, the results of the study showed that SCC was directly related to high-risk infection of HPV.There were 48 high risk HPV pa-tients with an average age of 43.6, and 82 low risk HPV patients with an average age of 32.7, with statistically significant differ-ence（P〈0.05）. Conclusion Liquid based cytology combined with HPV genotyping can effectively diagnose the cervical cancer le-sions, and the data are comparatively accurate and reliable, so it is worthy of clinical application and promotion.